Child care bites common, but rarely infectious

NEW YORK (Reuters Health) - Placing your young bundle of joy into childcare will exposes him or her to potential bites from other children, but a Canadian group reports these bites rarely break the skin and pose a minimal risk of infection.

Research suggests a biting episode occurs each day in larger childcare settings - those with full-time enrollment of 60 children, aged three years and younger.

However, a bite that breaks the skin occurs only about every 8 to 10 weeks, according to a statement released by the Canadian Paediatric Society in Ottawa, Ontario.

"Although the risk of infection is minimal, the level of parental anxiety may be high," writes the main author, Dr. Dorothy L. Moore, from The Montreal Children's Hospital and McGill University Health Centre in Montreal.

"Blood-borne viruses are very unlikely to be transmitted in child care settings," Moore and colleagues point out. While they found no cases of HIV or hepatitis C transmission in child care settings, bites that break the skin may transmit hepatitis B from an infected to a non-infected child.

Still, all bites deserve appropriate treatment.

Moore and colleagues compiled recommendations for the management of bites occurring in child care facilities. These recommendations, published in the journal Paediatrics and Child Health, update those published in 1998.

The recommendations suggest parents of both the biter and the recipient be apprised of all bites. Those that break the skin should initially "be allowed to bleed gently," then cleansed with soap and water, treated with a mild antiseptic, and observed for signs of redness, swelling, and infection.

Moore's group further recommends physician follow up on bites that break the skin, especially for deep wounds or those to the face, hand, foot, or genital area. These bites pose a slight risk for infection and may require subsequent immunization, medication, and followup testing.

Furthermore, child care centers should have written policies that outline methods for dealing with children who bite and those bitten, as well as staff adequately trained to minimize and respond to all children involved in biting, Moore and colleagues note.

SOURCE: Paediatrics and Child Health, July/August 2008